Periodontal maintenance is structured supportive care after active periodontal treatment. Each visit reassesses disease stability, plaque control, bleeding, pockets, risk factors and restorative or implant concerns; the interval is individualised and active disease is retreated rather than managed by routine cleaning alone.
Contents
What is supportive periodontal care?
Supportive periodontal care begins after completion and evaluation of active therapy. Its purpose is to preserve treatment gains, detect recurrence, reinforce self-care and manage modifiable risk factors. It is distinct from a routine prophylaxis because it is based on a documented history of periodontitis and site-specific risk.
Core components of a maintenance visit
- Update medical, medication, smoking and diabetes information.
- Assess plaque, gingival inflammation and patient-performed biofilm control.
- Record probing depths, bleeding, suppuration, recession, mobility and furcation findings according to risk.
- Review radiographs only when clinically indicated.
- Remove supra- and subgingival deposits at indicated sites.
- Evaluate implants, restorations and prostheses that affect cleansability.
- Retreat active sites or refer when disease control is inadequate.
How is the interval selected?
There is no single interval for every patient. Shorter intervals may be appropriate when residual deep pockets, bleeding, rapid prior progression, smoking, poorly controlled diabetes, inadequate plaque control or complex implants are present. Stable patients with effective self-care may be reviewed less frequently. The interval should change when risk changes.
Risk-based maintenance table
| Finding | Interpretation | Clinical response |
|---|---|---|
| Stable shallow sites with minimal bleeding | Controlled condition | Continue supportive care and reinforce self-care |
| Residual pocket with bleeding | Site-level recurrence risk | Reinstrument, assess cause and review response |
| Increasing attachment or bone loss | Active progression | Re-diagnose, retreat or refer |
| Poor plaque control or smoking | Elevated patient risk | Behavioural support and shorter reassessment |
| Implant bleeding or suppuration | Possible peri-implant disease | Full implant assessment and timely treatment |
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Frequently asked questions
Is periodontal maintenance the same as scaling?
No. Instrumentation may be included, but maintenance also requires reassessment, risk control, diagnosis of recurrence and personalised planning.
Does every patient need a three-month recall?
No. Recall is individualised according to disease stability, residual pockets, bleeding, risk modifiers, self-care and previous progression.
Can maintenance replace retreatment?
No. Progressive attachment loss, persistent inflammation or uncontrolled deep sites require renewed diagnosis and active treatment.